Complications of Lipomodelling Following Breast Surgery, Is It a Safe Procedure?

Background: Lipomodelling has been increasingly used recently for the correction of defects and asymmetry following oncologic breast cancer treatment. The current evidence on the efficacy of breast reconstruction using lipomodelling after breast cancer treatment is inadequate and the evidence raises no major safety concerns. Objective: We have audited our outcome results against the NICE guideline criteria for both safety and efficacy. Data was collected retrospectively of all the lipomodelling cases performed in Northumbria Healthcare NHS Foundation Trust between 04/2011-04/2013. Methods: A total of 36 patients was included in the study, the average amount of fat injected was 113.91 mls per session, Cytori technique gave the least complication rate 11% vs Coleman and body jet techniques 44% and 45% respectively. Results: We met the NICE guideline criteria in; the number of sessions for each patient, the duration of hospital stays and we documented the amount of fat harvested and injected into each patient. We didn't fulfill the guidelines in volume change; as no definite tool was used other than the clinical assessment; 80% were very good and good aesthetic outcome compared to NICE's 87%, while the aesthetic outcome was absent in 8% compared to NICE's 2.7%. Regarding the safety, we met the NICE's guidelines for local recurrence rates <1%, and local infection rate<1%, as well as pneumothorax and fat embolism (0%). However; we had a high liponecrosis rate 13% vs 3%, and liponecrotic cysts (8.33% vs 7%), these were more frequent with Bodyjet technique. Conclusion: Lipomodelling is a safe procedure following breast cancer surgery, which can be carried out at District general hospitals levels with comparable outcomes.